Surgical rongeur

ABSTRACT

An improved rongeur for cutting bone or cartilage comprising two shaft members capable of reciprocating motion relative to each other wherein one shaft member terminates in a foot plate and the other shaft member comprises a combined cutting element and storage member is disclosed. The combined cutting element and storage member has a cutting edge at its distal end and a storage chamber proximate the cutting edge for collecting and storing cut pieces of bone or cartilage in an amount greater than the maximum bone or cartilage capable of being cut in a single full cut. The combined cutting element and storage member is truly disposable, rather than merely replaceable and requires the use of no tools or special assembly. The rongeur may be manually activated or activated by a solenoid and powered by a battery.

RELATED APPLICATIONS

This is a continuation of application Ser. No. 10/457,117, filed on Jun.9, 2003, now U.S. Pat. No. 7,922,723, which is a continuation ofapplication Ser. No. 09/570,754, filed May 15, 2000, now U.S. Pat. No.6,575,977, which is a continuation of application Ser. No. 08/905,360,filed Aug. 4, 1997, now U.S. Pat. No. 6,142,997, which is a divisionalof application Ser. No. 08/337,107, filed Nov. 10, 1994, now U.S. Pat.No. 5,653,713, which is a continuation in part of application Ser. No.08/108,908, filed Aug. 18, 1993, now U.S. Pat. No. 6,200,320, which areincorporated by reference herein.

BACKGROUND OF THE INVENTION

1. Field of the Invention

This invention relates to surgical Instruments, used to bite out or cutportions of bone or cartilage, and specifically to those of the Kerrisontype, or similar type.

2. Description of the Related Art

Rongeurs are surgical instruments for the cutting away of human tissue,and most commonly, cartilage and/or bone. Kerrison rongeurs are utilizedin spinal surgery to remove bone and to thereby gain access to thespinal canal. These rongeurs typically have a closable jaw, one memberof which having a cutting end and the other member being a foot platewhich must be placed beneath the tissue, generally bone or cartilage, tobe cut.

For example, when a Kerrison rongeur is in use, the surgeon places thebone to be cut, such as the leading edge of the lamina of a vertebrae,within the open portion of the distal end of the rongeur. The surgeonthen squeezes the handle of the rongeur which causes the moveable jawmember of the rongeur to be advanced through that portion of bone toreach the foot plate, and thereby amputating that portion of bone. Oncethe jaw members become full, the rongeur must then be completely removedfrom the surgical site and passed to the scrub nurse for the removalfrom the Instrument of that cut portion of bone.

To facilitate the necessary function of the rongeur, the foot plate isgenerally cupped, as is the cutting end of the moveable jaw member. Ifonly the moveable jaw member were cupped and the foot plate flat, thenupon cutting with such an instrument the bone would be so compacted intothat singular cup as to make it nearly impossible to remove the portionof bone cut. However, because the foot plate of the Kerrison rongeur isbelow the lamina and proximate to the dural sac, spinal cord, and nerveroots, there is a compelling need to avoid any excessive thickness ofthe foot plate itself. Therefore, the foot plate cup is generally notquite as deep as the cup in the moveable jaw member and thus, even inthe double cup design, the cut portion of bone tends to be compactedproximally, making its removal nevertheless difficult. The removal fromthe instrument of the cut portion of bone often requires that the scrubnurse use a small rigid hook, or toothed forceps, and often furtherrequires that the physician temporarily relinquish the instrumententirely to make such bone removal possible. Once cleaned, theinstrument is returned to the surgeon who, in returning it to thesurgical site, must then reorient himself to the task at hand. Thissequence must then be repeated over and over again with each cut ofbone. Typically, such spinal procedures unfortunately require many suchcuts.

Essentially flat foot plates had been in use earlier this century, butproved to be undesirable because the opening of the jaw members to beable to get around the thickened portions of the vertebrae tended toexceed the capacity of the cup in the moveable jaw member and the bonecut would be markedly compressed during the cutting process. When thefoot plate is flat, the mass of bone bitten is forcefully compacted intothe singularly cupped recess of the movable jaw member such that it isextremely difficult to remove that bone after each cut.

A consideration of the structure and function of the prior art rongeurs,and specifically in regard to the foot plate structure and its requisitethickness, is quite revealing. It would appear that in use the footplate is subjected to five types of forces.

Consistent with its intended purpose, the foot plate is subjected to,and must withstand, that force necessary to actually cut through thebone, which shall be referred to as the Bone Cutting Force. However, thesurgeon has no way of knowing what that force is, or even when he hasreached or exceeded it. Accordingly, the foot plate is invariablyexposed to a second force significantly greater than the Bone CuttingForce which shall be called the Terminal Squeezing Force. The TerminalSqueezing Force occurs after the bone fragment has been cut and iscaused by the surgeon generating force in excess of the Bone CuttingForce. This results in the relatively massive slide portion of theinstrument being driven with great mechanical advantage against the footplate. This occurs because the manufacturer of such a rongeur must allowfor wear of the cutting surfaces and still allow for the jaw to still beable to close such that the slide portion of the instrument has agreater excursion than would be otherwise required to merely close thejaw members of the rongeur when the cutting surfaces are new.

A third force encountered by the foot plate is a product of the factthat the instrument jaw generally opens to an extent greater than thecombined depths of the cups such that the solid bony contents arephysically crushed. This is the Bone Crushing Force, and again isadditional to the Bone Cutting Force.

A fourth force that may impact upon the foot plate is that which occurswhen the jaws of the rongeur encounter an object, which because of itsphysical structure, is unbiteable. In this situation, while the jaw isstill in a relatively open position, again a force greater than the BoneCutting Force is generated and in this case is then transmitted throughthe unbiteable object to the foot plate.

The fifth force to which the foot plate is subjected is leverage. Whenthe jaws are not sufficiently sharp, or are worn such that they fall tocompletely close, then the bone will not be completely cut through, andthe surgeon will rock the instrument back and forth to fracture throughthe remaining bony bridge. In this situation, the angle of the jaw incontact with the leading edge of the lamina becomes the fulcrum pointand the foot plate, measuring generally less than half of an inch inlength, is one lever arm, while the remainder of the instrument throughthe shaft and handle is the other. Since these instruments generallymeasure on the order of approximately 10 inches, the mechanicaladvantage, or force applied to the tip in a rocking maneuver is on theorder of magnitude of 20 to 1.

The ability to safely withstand repeated exposure to these five forces,and the previously discussed need to cup the inner surface of the footplate, have in the past, determined the requisite thickness of the footplate.

At present, there is also a need for a rongeur with a capacity to remainwithin the wound and to repeatedly bite bone and to store the bonebitten until all the requisite bone removal has been completed withoutthe need to continuously remove the rongeur from the wound for thepurpose of removing the cut portion of bone from the instrument to clearthe cutting edges. A further and related need exists for a rongeur thatwould collect and contain all of the bitten material such that thedelicate neural structures would be protected from contact with thebitten material and/or any cogenerated inadvertent debris. In thisregard, any rongeur can bite more than once, but not properly. That is,one could deliberately take several small bites, each of which wouldfail to fill the cup in the foot plate and the singularly cupped recessof the moveable jaw member, in lieu of taking one full bite. However,once the cup in the foot plate and the cupped recess of the moveable jawmember are filled, further biting is not possible. Bone may be crushedas cups that are already full approach one another, but their contentswill shield any further interposed bone from the cutting edges, thusmaking any further bone cutting impossible.

An example of a multibite rongeur is shown in U.S. Pat. No. 3,902,498issued to Niederer on Sep. 2, 1975. Niederer teaches the use of arongeur hollow at the tip such that it is possible to take severalbites. Unfortunately, since the hollow tip is open to the wound at bothends, the further use of the instrument pushes the already bittenmaterial out of the other end of the hollow tip and back into the depthsof the surgical wound where it can cause great harm. This shortcoming ofNiederer can not be overcome by simply closing off the second opening asthe operation of the instrument requires the second cutting member (8)to pass through the same area that the ejected bone had occupied.

Further, if a rongeur could take and then store safely, multiple fullbites of bone, a rationale would then exist for a power rongeur. A priorart power rongeur was marketed by the 3M Company. However, it was verybulky and required a large bore hose connection to a non-sterilecompressed gas tank making the instrument very unwieldy. The bitingmechanism itself was rather slow and clumsy and the instrument stillrequired removal from the wound after every bite to clean out the bittenportions of bone.

There is also a need for a disposable cutting means so that thoseportions of the rongeur involved in the actual cutting may be easilyrenewed as these portions of the rongeur rapidly wear and dull from thecutting of bone. With wear comes both edge dullness and non-mating ofthe contact surfaces rendering the rongeur ineffective and evendangerous as it fails to cut cleanly and begins to rely on tearing.

Both U.S. Pat. No. 3,902,498 issued to Niederer and U.S. Pat. No.5,026,375 issued to Linovitz et al. disclose a means for replacing thecutting element on just one side of the jaw in a rongeur appearing tohave cutting cupped portions on both sides of the jaw. Since dulling andwear occurs equally on both sides of the jaw, replacing only one side isobviously ineffective in restoring the sharpness and the full cuttingfunction of the instrument or for even providing for the proper matingof the cutting surfaces as one new side is then opposed to one wornside.

Reference is made to U.S. Pat. No. 4,722,338 to Wright et al. and U.S.Pat. No. 4,777,940 to Wright et al. U.S. Pat. No. 4,777,948 discloses arongeur having a stationary hollow tubular cutting element 28 which maybe removably attached to the rongeur. The entire assembly must bedisengaged to replace the cutting element. The device is not capable oftaking multiple full bites since only a short recess is provided forpulling the severed bone into the hollow cutting tube and contrary tothat concept teaches that the bone is then ejected after each cuttingoperation, as explained in U.S. Pat. No. 4,722,338 at Col. 3, line 10.No collection of the cut bone is achieved by the hollow cutting elementbeyond a single cut and the cut bone is then ejected. In fact, the cutbone may be ejected into the wound, which could cause great harm.

Finally, there is a need for a Kerrison type rongeur that is capable oftaking larger bites of bone than is now possible. While the need forsuch a rongeur exists, by prior art technology the foot plate would betoo thick to safely use beneath the lamina, and the surgeon would lackthe strength to crush and compact that volume of bone.

There is therefore a need for a Kerrison type rongeur with a thin, butstrong, foot plate that would be able to take and safely storethroughout the operation multiple full bites of bone. Such a rongeurwould also have at least a disposable cutting element system capable ofreplacing all cutting edges to provide for the surfaces of the cuttingedges to be sharp and close perfectly and would be capable of takinglarger bites of bone than previously possible. Such a rongeur could bepowered without the need for external connections to a remote powersource.

SUMMARY OF THE INVENTION

The present invention is a rongeur for cutting bone or cartilagecomprising two shaft members capable of reciprocating motion relative toeach other wherein one shaft member terminates in a foot plate and theother shaft member comprises a combined cutting element and storagemember. The combined cutting element and storage member has a cuttingedge at its distal end and a storage chamber proximate the cutting edgefor collecting and storing cut pieces of bone or cartilage in an amountgreater than the maximum bone or cartilage capable of being cut in asingle full cut. In one embodiment of the present invention the surgicalrongeur is an ultra-thin foot plate, multi-bite (capable of takingmultiple full bites) rongeur with a combined cutting element and storagemember that is replaceable and disposable. The combined cutting elementand storage member comprises a removable and disposable straw memberhaving a sharp cutting end and an end that removably attaches to anengagement means for engaging the straw member to a carriage member suchthat the end is closed while in use. The combined cutting element andstorage member is removably locked to at least one of the two shaftmembers.

The reciprocating motion of the two shaft members causes the combinedcutting element and storage member and a foot plate to close and open inresponse to the activation of a driving member which may be handoperated or powered by a solenoid. The foot plate of the rongeur of thepresent invention is ultra-thin, such that it is substantially thinnerthan the foot plates of the rongeurs of the prior art. The ultra-thinfoot plate of the present invention is made possible by the relativeabsence of any recess sufficient to hold bone after a cut is made and issubstantially flat. The foot plate of the present invention need not beas thick as that of a conventional rongeur since the only force normallyapplied to it is that sufficient to actually cut the bone being bitten.

In one embodiment of the present invention, the foot plate-shaftjunction area of the rongeur is designed to prevent the upward excursionof the combined cutting element and storage member along the foot plate.The terminal squeezing force is eliminated by providing a proximal stopto the movement of the slide portion of the instrument allowing only forthe full opposition of the foot plate and combined cutting element andstorage member but allowing no further motion. This absence of furthermotion in opposition to the foot plate thus serves to consequentlyprotect it.

The bone compaction force that occurs with prior art rongeurs resultsfrom the fact that the rongeur must—to serve its purpose—open to anextent sufficient to accept the thickness of the bone being cut, whichcommonly exceeds the capacity of the two cupped surfaces. However, thepresent invention has no fully cupped surfaces and in fact the combinedcutting element and storage member is functionally bottomless untilfull.

The force associated with levering is eliminated by eliminating the needfor it which generally arises from a need to complete the cutting out ofa piece of bone by fracturing through the remaining portion when suchcutting is incomplete because of dulling of the cutting elements or afailure of them to fully and uniformally coapt. In the instance of thepresent invention as the cutting element is not only replaceable, butdisposable, and as there is but a single cutting element which isreplaceable for each new procedure the surgeon is assured that all ofthe cutting surfaces are optimally sharp and unworn such that thosebiting surfaces coapt perfectly. Prior art rongeurs that replaced butone of two equally important cutting edges failed to either restore fullsharpness or to provide for perfect coaptation of those cuttingsurfaces.

During use, the combined cutting element and storage member is closed atits proximal end and open at its distal end terminating in anultra-sharp cutting surface. Inasmuch as the combined cutting elementand storage member is hollow, rather than cupped, and the opposedsurface of the foot plate is substantially flat, the bone bitten isalways driven rearward into the storage member portion. As the storagechamber is closed while in use except for the cutting entrance, it maybe used to repeatedly bite bone without the danger of the bone bittencoming free and falling into the spinal canal in contradistinction toprior art rongeurs which required the ejection of bone before a secondfull bite could be taken.

When the present invention has completed its task and has removed all ofthe bone as needed, the combined cutting element and storage member maybe removed from the shaft of the rongeur and the bitten bone may beremoved from the storage member and made available for use, as inperforming a spinal fusion.

The present invention allows for the clean cutting of bone or cartilagewithout any significant compaction. Further, as the combined cuttingelement and storage member of the present invention is disposable andthus always fresh and sharp, less force is required during the actualcutting of the bone. In addition, since the combined cutting element andstorage member is always fresh and sharp, edge wear is not a problem andthe capacity for further excursion of the combined cutting element andstorage member towards the foot plate is unnecessary and may becompletely blocked, thereby sparing damage to the foot plate.

Further, the present invention has a combined cutting element andstorage member that is truly disposable, rather than merely replaceableand requires no special assembly or the use of any tools. The combinedcutting element and storage member is simply placed onto one of theshaft members whereby it is immediately locked into place by the use ofthe instrument itself.

Finally, as the rongeur of the present invention is capable of takingrepeated and uninterrupted multiple full bites of bone or cartilage,there is a compelling rationale for the incorporation of a power meansto drive the rongeur and a self-contained power source to further allowthe use of the rongeur to be unfettered.

OBJECTS OF THE PRESENT INVENTION

It is an object of the present invention to provide an improved surgicalrongeur capable of taking multiple full bites of bone or cartilagewithout having to be removed from the wound after each bite.

It is another object of the present invention to provide an improvedsurgical rongeur capable of storing multiple cut pieces of bone orcartilage while the rongeur is in the wound.

It is yet another object of the present invention to provide an improvedsurgical rongeur having a combined cutting element and storage member.

It is a further object of the present invention to provide an improvedsurgical rongeur having a combined cutting element and storage memberthat is easily replaceable and disposable.

It is yet a further object of the present invention to provide animproved surgical rongeur having a replaceable and disposable combinedcutting element and storage member that does not require the use oftools or special assembly.

It is still a further object of the present invention to provide animproved surgical rongeur having a combined cutting element and storagemember which is simply placed onto the shaft of the rongeur, whereby itis immediately locked into place by the use of the rongeur.

It is another object of the present invention to provide an improvedsurgical rongeur with an ultra-thin foot plate.

It is a further object of the present invention to provide an improvedsurgical rongeur having an improved button assembly for controlling thedisplacement of a driving means along the shaft of the rongeur and forcontrolling the engagement or release of a combined cutting element andstorage member, that also functions as a hinge for attaching the handleto the body of the rongeur.

It is another object of the present invention to provide an improvedsurgical rongeur having an improved means for the rapid engagement anddisengagement of a disposable combined cutting element and storagemember.

It is yet another object of the present invention to provide a surgicalrongeur capable of taking multiple full bites which is activated by asolenoid.

It is still another object of the present invention to provide anelectrical rongeur having a battery as a self-contained power source.

It is another object of the present invention to provide a surgicalrongeur having a removable shaft portion which can be made in a varietyof sizes and configurations and be interchangeably coupled to a manualor power handle means, wherein at least a portion of the removable shaftportion may be disposable.

It is still another object of the present invention to provide asurgical rongeur having a combined cutting element and storage member incommunication with a vacuum means for evacuating any contents of thecombined cutting element and storage member.

These and other objectives of the present invention shall be more clearupon review of the following detailed description of the drawings whenreviewed in conjunction with the accompanying drawings.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 is an elevational side view of a surgical rongeur constructed inaccordance with the present invention.

FIG. 2 is an exploded first side view of the surgical rongeur of FIG. 1.

FIG. 3 is an exploded second side view of the surgical rongeur of FIG.1.

FIG. 4 is an exploded view of the surgical rongeur of FIG. 1 showing abottom plan view of the slide drive member engaged to thecutting/storage member and an elevational second side view of the body.

FIG. 5 is a top plan view along lines 5-5 of FIG. 4 showing theconfiguration of the slot and recess of the shaft portion of thesurgical rongeur of FIG. 1.

FIG. 6 is a cross sectional view along lines 6-6 of FIG. 1 illustratingthe cutting/storage member engaged to the shaft of the surgical rongeurof FIG. 1.

FIG. 7 is a partial schematic view of the spring means for biasing thehandle of the surgical rongeur of FIG. 1.

FIG. 8 is a perspective view of an alternative embodiment of thecutting/storage member of the surgical rongeur of the present inventioncomprising a disposable storage and cutting element.

FIG. 9 is a bottom plan view of a further alternative embodiment of thesurgical rongeur of the present invention comprising a disposablecombined cutting element and storage member, secured to the bottomportion of a carriage member.

FIGS. 10A and 10B are partial elevational side views of alternativeembodiments of the foot plate having a groove and the cutting/storagemember having an extension element for preventing upward excursion ofthe cutting/storage member along the foot plate.

FIG. 11 an elevational and partial sectional side view of anelectrically powered surgical rongeur of the present invention.

FIG. 12 is a cross sectional view along lines 12-12 of the electricallypowered surgical rongeur of FIG. 11.

FIG. 13 is a cross sectional view along lines 13-13 of the electricallypowered surgical rongeur of FIG. 11.

FIG. 14 is a cross sectional view along lines 14-14 of the electricallypowered surgical rongeur of FIG. 11.

FIG. 15 is an elevational and partial sectional side view of anotheralternative embodiment of the electrically powered surgical rongeur ofthe present invention.

FIG. 16 is a partial elevational and partial sectional side view ofanother alternative embodiment of the electrically powered surgicalrongeur of the present invention.

FIG. 17 is an elevational side view of an alternative embodiment of thesurgical rongeur of the present invention.

FIG. 18 is a partial elevational front view along view lines 18-18 ofthe surgical rongeur of FIG. 17 showing the release button in theengaged position.

FIG. 19 is a partial elevational front view along view lines 18-18 ofthe surgical rongeur of FIG. 17 showing the release button in thedisengaged position.

FIG. 20 is a partial, exploded elevational side view of the surgicalrongeur of FIG. 17.

FIG. 21 is a side perspective view of the cutting/storage member of thesurgical rongeur of FIG. 17 with the straw member shown in partialcutaway and in the elevated position.

FIG. 22 is a bottom plan view of the cutting/storage member of thesurgical rongeur of FIG. 17 with the straw member shown in the loweredposition.

FIG. 23 is a cross sectional view along lines 23-23 of FIG. 21 of thestraw engagement means of the cutting/storage member of FIG. 21 shown inthe raised position with the lowered position shown in hidden line.

FIG. 24 is a cross sectional view of the cutting/storage member alonglines 24-24 of FIG. 22.

FIG. 25 is a cross sectional view along lines 23-23 of FIG. 21 of analternative embodiment of the straw engagement means shown in the raisedposition with the lowered position shown in hidden line.

FIG. 26 is a side elevational view of an alternative embodiment of thesurgical rongeur of the present invention having a reciprocating shaftterminating in a foot plate and a fixed body portion.

FIG. 27 is a top plan view along lines 5-5 of FIG. 4 showing analternative embodiment of the surgical rongeur of the present inventionhaving a shaft with a removably attachable end portion.

FIG. 27A is a cross sectional view along lines 27A-27A of FIG. 27showing the engaging means for removably engaging the end portion to theshaft of the surgical rongeur of FIG. 27.

FIG. 27B is a partial side sectional view of an alternative embodimentof the foot plate having a cutting surface which is out of the plane ofthe surface of the foot plate facing the cutting edge of thecutting/storage member of the present invention.

FIG. 27C is a partial side sectional view of an alternative embodimentof the foot plate having a cutting surface which is out of the plane ofthe surface of the foot plate facing the cutting edge of thecutting/storage member of the present invention.

FIG. 28 is a partial elevational side view of an alternative embodimentof the surgical rongeur of the present invention for use in endoscopicsurgical procedures.

FIG. 29 is a cross sectional view along lines 29-29 of the endoscopicsurgical rongeur of FIG. 28.

FIG. 30 is an exploded elevational side view of an alternativeembodiment of the surgical rongeur of the present invention havingremovably attachable shaft members.

FIG. 31 is a cross sectional view of the engagement means for engagingthe removably attachable shaft members of the surgical rongeur of FIG.30 shown partially inserted.

FIG. 32 is a cross sectional view of the engagement means for engagingthe removably attachable shaft members of the surgical rongeur of FIG.30 shown fully inserted.

FIG. 33 is a partial elevational side view and schematic diagram of analternative embodiment of the surgical rongeur of the present inventionhaving a vacuum pump in communication with the cutting/storage memberfor evacuating any contents of the cutting/storage member.

DETAILED DESCRIPTION OF THE DRAWINGS

Referring to FIGS. 1-4, the improved surgical bone rongeur 10 is shownconstructed in accordance with the present invention and comprisesgenerally of a body 12 having a rear handle 13 depending at an anglefrom the proximal end 11 of the body 12, and has a shaft 14 extendingdistally and terminating at its distal end in a foot plate 16. A supportspike 31 extends from the upper portion of the rear handle 13 as supportfor the area of the hand between the thumb and the first finger. Mountedon the shaft 14 is a slide drive member 20 for reciprocating movement onthe shaft 14.

Referring to FIG. 2, a pivoting forward handle 30 includes a lowerfinger grip portion 34 and an upper finger portion 37 for the fingers.The upper part of the forward handle 30 has an extension 33 with anelongated opening 35 and an aperture 36 through which passes a pivot pin32. Extension 33 fits into the body 12 through slot 19 (shown in FIG. 5)and is contained within the body 12.

Once the extension 33 is positioned within slot 19, the pivot pin 32,having a screw head 39 on one end and threads at its other end, is usedto pivotally attach the forward handle 30 to the body 12. The pivot pin32 passes through opening 15 in one side of the body 12 through aperture36 in the forward handle 30 and threads into threaded aperture 17 in theother side of the body 12. The elongated opening 35 of the extension 33surrounds pin 42 located at the bottom surface of slide drive member 20which is mounted on the shaft 14 so that the forward handle 30 engagesthe pin 42 and serves as the driving means for the slide drive member20. The forward handle 30 is attached to the body 12 at an angle to theslide drive member 20 so that when the forward handle 30 movesproximally the slide drive member 20 moves distally. The forward handle30 and the rear handle 13 are biased away from each other by springmeans 40 and 40 a. Spring means 40 is attached at one end to the bottomof forward handle 30 by screw 41 and spring means 40 a has one endattached to the bottom of rear handle 13 by screw 43 and may be furthersecured by having a bend in the end of spring means 40 a capable offitting into an opening of rear handle 13 to prevent rotation of thespring means 40 a relative to rear handle 13.

Referring to FIG. 7, in order to interlock the two spring means 40 and40 a, spring means 40 has an extension piece 45 at its upper end thatfits into the notch 46 of the upper end of spring means 40 a. Onceinterlocked, the spring means 40 and 40 a oppose each: other to bias theforward handle 30 distally. Other spring mechanisms, internal orexternal, and other biasing means, including pneumatic means, may alsobe employed for urging the forward handle 30 distally.

Referring to FIGS. 4 and 5, the slide drive member 20 is slidablymounted to the top surface of shaft 14 within a slot 24 formed in theshaft 14 having an inverted T-shaped portion 25 into which is fitted acomplementary inverted T-shaped runner 26 depending from the bottomsurface of slide drive member 20. Slot 24 extends distally from theinverted T-shaped portion 25 to form a wider portion 27 of the slot 24.

Referring to FIG. 4, a stop pin 60 depends from the distal end 61 of thebottom surface of the slide drive member 20. The stop pin 60 serves toguide the slide drive member 20 and to keep the distal end 61 of theslide drive member 20 from sliding off the shaft 14 during the operationof the rongeur 10. The stop pin 60 is set back from the distal end 61 ofthe slide drive member 20 and fits within the wider portion 27 of slot24. The wider portion 27 of the slot 24 has a slot wall 28 at its distalend which catches the stop pin 60 and prevents the slide drive member 20from sliding off the shaft 14 distally.

Referring to FIGS. 2 and 5 on one side of the shaft 14 is a roundedaperture 80. The rounded aperture 80 corresponds in location to a recess82 in the top surface of shaft 14 as shown in FIG. 5. The recess 82bisects the wider portion 27 of slot 24 and has a rounded bottomsurface. Located within the recess 82 and extending from the aperture 80is a push button assembly 70 having a large diameter, external buttonportion 76 and a narrow diameter portion 74 that passes through theaperture 80. The narrow diameter portion 74 has a depression 75 with aflat bottom. The narrow diameter portion 74 terminates at its other endin a large diameter member 72 having a slightly smaller diameter thanthe diameter of the rounded recess 82. The large diameter member 72 hasa flattened top surface 73 so that it is flush with the top surface ofthe shaft 14 when the large diameter member 72 is inserted within therecess 82. The reverse end of the large diameter member 72 has a smalldepression 77 for receiving the end of a coil spring 84 a shown in FIG.4.

The large diameter member 72 is placed within the recess 82, so that thenarrow diameter portion 74 crosses the wider portion 27 of the slot 24at a right angle and extends through the rounded aperture 80 and theexternal button portion 76 is external to the shaft 14. The depression75 in the narrow diameter portion 74 is of a sufficient depth to permitthe stop pin 60 depending from the slide drive member 20 to easily passthrough the wider portion 27 of the slot 24 and over the depression 75unobstructed by the narrow diameter portion 74.

Within the recess 82 is a coil spring 84 having an end that fits withinthe small depression 77 of the large diameter member 72. The coil spring84 serves to bias the large diameter member 72 so that in its biasedposition, the large diameter member 72 blocks the wider portion 27 ofslot 24. The large diameter member 72 has a diameter that is sufficientto prevent the stop pin 60 from sliding over it. The external buttonportion 76 is at its greatest extension out of the rounded opening 80when the large diameter member 72 is in the biased position and blocksthe wider portion 27 of the slot 24. To unblock the wider portion 27 ofthe slot 24, the user simply presses the external button portion 76 ofthe button assembly 70 so that the coil spring 84 compresses and thelarge diameter member 72 moves further into the recess 82. When thelarge diameter member 72 is positioned as far into the recess 82 aspossible the depression 75 of the button assembly 70 is positioneddirectly beneath the stop pin 60 depending from the bottom surface ofthe slide drive member 20 so that the stop pin 60 can pass through thewider portion 27 of the slot 24 unobstructed.

It is appreciated that the rounded recess 82 may be placed at variouslocations along the shaft 14 so that the button assembly 70 containedtherein may also be positioned at various locations along the shaft 14beneath the slide drive member 20. The position of the stop pin 60depending from the slide drive member 20 may also be changed tocorrespond to the location of the button assembly 70 and theconfiguration of the slot 24 and the position of the wider portion 27may also be modified accordingly without departing from the scope of thepresent invention. For example, the rounded recess 82 may be replacedalong the shaft 14 so that it is located within the opening 15 and thethreaded aperture 17 of the body 12. In this position, the buttonassembly 70 in addition to controlling the displacement of the slidedrive member 20 along the shaft 14 could also serve as a hinge andattachment means for the forward handle 30 replacing the pivot pin 32 asshown in FIG. 17.

Referring to FIGS. 5 and 6, the shaft 14 has a pair of rails 62,63extending from either side of the shaft 14 which run parallel to theshaft 14. The rails 62,63 have a bottom substantially flat surface 64that is perpendicular to the sides of the shaft 14 as shown in FIG. 6.Near the distal end of the shaft 14 are forward notches 65,66 thatprovide a break in the continuity of the rails 62,63. Positionedproximal to the forward notches 65,66 are rear notches 69,71 whichsimilarly provide a break in the continuity of the rails 62,63.

Referring to FIGS. 4 and 6, the distal end 61 of the slide drive member20 engages a cutting/storage member 50 which is removably attached toboth the shaft 14 and to the slide drive member 20. The cutting/storagemember 50 has depending sides 51 and 52 which are mirror images of eachother. As shown in FIG. 4, near the distal end of the cutting/storagemember 50, the depending sides 51,52 each have forward rail-engagingmembers 53,54 respectively. Forward rail-engaging members 53,54 fitwithin the forward notches 65,66 of shaft 14. Each of the forwardrail-engaging members 53,54 has a top substantially flat surface 68 thatis perpendicular to the depending sides 51 and 52 for engaging thebottom substantially flat surface 64 of rails 62,63 as shown in FIG. 6.Once the forward rail-engaging members 53,54 are engaged to the rails62,63, the cutting/storage member 50 is prevented from sliding upward asit moves along the shaft 14.

Also located on each of the depending sides 51,52 of the cutting/storagemember 50 are rear rail-engaging members 56,57 which are sufficientlyspaced proximally from the forward rail-engaging members 53,54 so thatwhen the forward rail-engaging members 53,54 are placed over forwardnotches 65,66, the rear rail-engaging members 56,57 are directly overthe rear notches 69,71 in the shaft 14. The rear rail-engaging members56,57 are identical to the forward rail engaging members 53,54 andsimilarly each have a top substantially flat surface 68 for engaging thebottom substantially flat surface 64 of rails 62,63.

Referring to FIGS. 2 and 4, the proximal end of the cutting/storagemember 50 has a male connection means 55 having grooves 58 on both sidesof a key portion 59. The male connection means 55 fits into a femaleconnection means 21 located at the distal end 61 of the slide drivemember 20. The female connection means 21 has rails 23 for engaging thegrooves 58 of the male connection means 55 and a notched area 78 forreceiving the key portion 59. The cutting/storage member 50 may beengaged to the slide drive member 20 by lowering the cutting/storagemember 50 toward the slide drive member 20 so that the male and femaleconnection means 55 and 21 slide into each other. To disengage thecutting/storage member 50 from the slide drive member 20, the cuttingstorage member 50 is simply lifted out. As an alternative, thecutting/storage member 50 may also be attached to the slide drive member20 in any number of conventional ways, such as by snap fit.

The cutting/storage member 50 is placed on the shaft 14 by aligning theforward rail-engaging members 53,54 with the forward notches 65,66 andby simultaneously aligning the rear rail-engaging members 56,57 with therear notches 69,71 so that the male connection means 55 slides into andengages the female connection means 21 of the slide drive member 20. Inorder to properly align the cutting/storage member 50 so that it mayengage the shaft 14, the slide drive member 20 must be positionedsufficiently proximal from the foot plate 16.

The range of proximal to distal movement of the slide drive member 20 iscontrolled by the large diameter member 72 of the button assembly 70. Inits biased position, the large diameter member 72 is positioned in thewide portion 27 of slot 24 so that the distal edge 79 of the largediameter member 72 blocks the stop pin 60 and thus the slide drivemember 20 from moving proximally along shaft 14. The appropriateposition of the slide drive member 20 for attaching the cutting/storagemember 50 to the shaft 14 may only be achieved by sliding the stop pin60 past the position of the distal edge 79 of the large diameter member72. In order to slide the stop pin 60 past the distal edge 79, thebutton assembly 70 must be manually depressed toward the shaft 14 sothat the large diameter member 72 is pushed into the recess 82 and ismoved out of the wide portion 27 of slot 24. As the forward handle 30 isbiased forward by the spring means 40 and 40 a, the slide drive member20 is moved proximately along the shaft 14 so that the stop pin 60 ispositioned within the depression 75 of the narrow diameter portion 74.With the stop pin 60 positioned within the depression 75, the largediameter member 72 is pushed back within the recess and the coil spring84 is compressed within the recess 82 of the shaft 14.

Once aligned with the forward and rear notches 65,66 and 69,71 andengaged to the slide drive member 20, the cutting/storage member 50 isin position to be pushed distally along shaft 14 by the slide drivemember 20 toward the foot plate 16. This is accomplished by squeezingthe forward handle 30 to move the slide drive member 20 and the-stop pin60 distally so that the stop pin 60 is no longer within the depression75 of the narrow diameter portion 74, and the large diameter member 72is returned to its biased position by the coil spring 84. As thecutting/storage member 50 is engaged to the slide drive member 20, themovement of the cutting/storage member 50 is responsive to the movementof the slide drive member 20. As the cutting storage member 50 is moveddistally the front and rear rail-engaging members 53,54 and 56,57 engagethe rails 62,63.

Once the cutting/storage member 50 engages the rails 62,63 of the shaft14, it may not be lifted out and the cutting/storage member 50 is lockedto the shaft 14. The proximal movement of the slide drive member 20 isstopped by the large diameter member 72 in its biased position whichblocks the stop pin 60 from further proximal travel in the wider portion27 of the slot 24. To remove the cutting/storage member 50 from theshaft 14, the stop pin 60 must be again positioned by the user so thatit is within the depression 75 of the narrow diameter portion 74. Thus,the cutting/storage member 50 may be locked or unlocked to the shaft 14without the use of tools by simply pressing the button assembly 70.Further, once the button assembly 70 is pushed and the forward handle 34is advanced by the handle biasing means 40 and 40 a, the rongeur 10remains receptive to the introductions or removal of the cutting/storagemember 50 without the need to continue depressing the release button.

Further, the cutting/storage member 50 is secured to the shaft 14 bysimply pulling the forward handle 34 securing the cutting/storage member50 to the shaft 14 until the release button assembly 70 is againdepressed. The button assembly 70 does not have to be redepressed toallow pin 60 to move distally as portion 75 is of sufficient length tosupport it when the slide drive member 20 is maximally proximal.

The cutting/storage member 50 opens into a storage chamber 88 which isbounded by upper and side walls 44 and 85 which are sharpened distallyto form cutting edges 22 facing the foot plate 16. The depending sides51,52 of cutting/storage member 50 are recessed from the foot plate 16for maximum bite since no cutting edge is required at the dependingsides 51,52. While the foot plate 16 may have a slight concavedepression to allow for a cutting edge, it is to be understood that itis preferably substantially flat, without a cutting edge.

The storage chamber 88 extends along the interior of the cutting/storagemember 50 at least partially toward its proximal end. The crosssectional area of the interior of the storage chamber 88 may be constantor may progressively increase from the distal end to the proximal end sothat a number of successive bone fragments can more easily slide intothe storage chamber 88 and stack up without jamming.

The rongeur 10 of the present invention is used in the conventionalmanner to bite bone or cartilage. The cut bone fragments are pushed bythe foot plate 16, one by one, into a stack within the storage chamber88 of the removable cutting/storage member 50 after being cut and arenot likely to fall back into the wound site because they are forced intothe storage chamber 88 with considerable force and are prevented fromjamming as the cross sectional area of the interior space of the storagechamber 88 either has parallel or divergent walls. Thus, it is notnecessary that the cut bone fragments be removed during the surgicalprocedure, and bite after bite takes place, without the need to removethe rongeur 10 from the wound.

The side walls 44 and 85 of the cutting/storage member 50 have narrowslits 86,87 partially along the length of the cutting/storage member 50.Once the cutting/storage member 50 is filled with cut pieces of bone, itis removed from the shaft 14 and a stylet or similar instrument may beinserted through the slits 86,87 to aid in the removal of the cut piecesfrom the storage chamber 88 containing the cut pieces.

Alternatively, the proximal end of the storage chamber 88 of thecutting/storage element 50 may also be open. During use, the distal end61 of the slide drive member 20 may be used to block the open proximalend of the storage chamber 88. Once the cutting/storage member 50 isremoved from the rongeur 10, the proximal end of the storage chamber 88is open and a stylet may be used to push the cut bone fragments storedwithin the storage chamber 88 so that the fragments exit from the distalend or in reverse from the proximal end.

The use of a removable hollow cutting/storage member 50 permits a newsharp cutting edge to be provided for each operation as it may easily bereplaced. Both the storage chamber 88 and the cutting edge 22 could bemade of metal or any other suitable material such as, but not limitedto, ceramic for the cutting edge 22 or a plastic (e.g. polycarbonate)for the storage chamber 88.

In the preferred embodiment, the rongeur 10 has a body 12 that isapproximately 7¼ inches in length; a cutting/storage member 50 that isapproximately 3¼ inches in length and approximately ⅞ inches in heightand approximately ⅜ inches in width; a slide drive member 20 that isapproximately 3 9/16 inches in length and approximately 7/16 inches inheight and approximately ⅜ inches in width; a rear handle 13approximately 4⅞ inches in length and a front handle 30 approximately 4⅜inches in length having a extension member 33 that is approximately ⅞inches long; and a button assembly 70 having an overall length ofapproximately 7/16 inches.

It is appreciated that the cutting elements of the rongeur of thepresent invention need to be made of a material capable of forming asharp cutting edge and serving the intended purpose of the rongeur. Suchmaterials include, but are not limited to, metals, ceramics or compositematerials. The remainder of the rongeur could be made of metal, plasticor a composite material suitable for the intended purpose, such that theentire rongeur could be disposable.

Referring to FIGS. 8 and 9, in a first alternative embodiment of thepresent invention, the rongeur 10 includes a removable and disposablestraw 90 that is attachable to the bottom of a carriage member 96. Thecarriage member 96 is similar in construction to the cutting/storagemember 50 but does not have the storage chamber 88 and essentially actsas a housing for carrying the straw 90. Straw 90 is a hollow member inthe shape of a cylinder or may have any other shape suitable for usewith rongeur 10. At the distal end of the straw 90 is a sharp cuttingedge 92 for cutting bone or other similar tissue. In this embodiment,the cutting/storage member 50 is actually a carrier member as the straw90 does the actual cutting and storing of the bone. Prior to use, thestraw 90 is inserted within the storage chamber 88 before thecutting/storage member 50 is placed on the shaft 14. The hollow chamber94 of the straw 90 functions to store the cut pieces of bone orcartilage. The stored cut pieces may be removed for future use in thesame manner described above for the preferred embodiment.

The straw 90 is placed in the bottom of the carriage member 96 prior toplacing the carriage member 96 on the shaft 14. The straw 90 is held inplace and is prevented from rotating by pins 97,98 which complement thegrooves 101,102 in the straw 90 as shown in FIG. 9, and prevent anymovement of the straw 90 within the carriage member 96 during theoperation of the rongeur. Once the carriage member 96 is removed fromthe shaft 14, the straw 90 is easily removable from the carriage member96.

The straw 90 is preferably made of metal or any other material which iscapable of being sharpened and maintaining a sharp cutting edge 92 formultiple bites by the rongeur 10. After the straw 90 is used and removedfrom the rongeur 10, the cut pieces contained therein are removed andmay be used for bone grafting purposes if desired. The relatively lowcost of the straw 90 allows the straw 90 to be truly disposable.

Referring to FIGS. 10A and 10B, a second alternative embodiment of therongeur 10 is shown with the intersection of the foot plate 16 and theshaft 14 having a groove 29 such that the distal end of thecutting/storage member 50 or of a straw 90 has an extension element 38that complements the shape of the groove 29 and fits within the groove29. The extension element 38 may be made of the same material as thecutting/storage member 50. As a result of the angled orientation of thefoot plate 16, when the rongeur is fully closed, the cutting/storagemember 50 or the straw 90 tends to be forced up the inclination of thefoot plate 16 which may result in damage to the cutting edge 22 or 92.The combination of the groove 29 and the extension element 38 functionsto prevent any upward excursion of the cutting/storage member 50 orstraw 90 which would result in an overbite.

The operation of the rongeur 10 of the present invention is as follows:

The rongeur 10 is set in the “release position” by positioning the stoppin 60 within the depression 75 of the narrow diameter portion 74 of thebutton assembly 70. This in accomplished by manually pressing theexternal button portion 76 of the button assembly 70 so that the largediameter member 72 moves out of the wider portion 27 of the slot 24 tocompress the coil spring 84. The stop pin 60 may now freely pass by theposition of the distal edge 79 of the large diameter member 72 and tofit within the depression 75. As the spring means 40 and 40 a bias theforward handle 30 distally, the slide drive member 20 moves toward thefoot plate 16. With the stop pin 60 positioned within the depression 75,the coil spring 84 is kept compressed within the recess 82.

In the release position, the slide drive member 20 is positioned so thatthe cutting/storage member 50 may be easily placed on the shaft 14. Inthe release position, the forward rail-engaging members 53,54 arealigned with the forward notches 65,66 and the rear rail-engagingmembers 56,57 are aligned with the rear notches 69,71. Once aligned, thecutting/storage member 50 is positioned to easily engage the slide drivemember 20 so that the male and female connector means 55 and 21 mate andthe cutting/storage member 50 rests upon the shaft 14.

Once the cutting/storage member 50 is engaged to the slide drive member20, the forward handle 30 is squeezed by the user to advance the slidedrive member 20 so that the stop pin 60 exits from within the depression75 and the large diameter member 72 is returned by the coil spring 84 toits biased position to block the wider portion 27 of the slot 24. Withthe large diameter member 72 in this position, the stop pin 60 isstopped from any further proximal movement past the distal edge 79 ofthe large diameter member 72 thereby preventing any further proximalmovement of the slide drive member 20 past the large diameter member 72.With the slide drive member 20 in this position, the forward and rearrail engaging members 53,54 and 56,57 are engaged to the rails 62,63 andare no longer aligned with the forward and rear notches 65,66 and 69,71.Therefore, the cutting/storage member 50 is securely locked to the shaft14 and may not be removed from the shaft 14.

With the cutting/storage member 50 in the locked position on the shaft14, the rongeur 10 may be placed in the wound and used to take multiplebites or cuts of the selected tissue with the cut pieces being storedwithin the storage chamber 88 of the cutting/storage member 50. Once thedesired number of bites has been attained or if the storage chamber 88becomes filled, the rongeur 10 is removed from the wound. Thecutting/storage member 50 is removed from the shaft 14 of the rongeur byreturning the rongeur to the release position by pressing the externalbutton portion 76 as described above, so that the forward and rearrail-engaging members 52,54 and 56,57 are once again aligned with theforward and rear notches 65,66 and 69,71 and no longer engage the rails62,63. The cuffing/storage member 50 is then easily lifted up and awayfrom the shaft 14.

The cut pieces may be removed from the storage chamber 88 by inserting astylet in the slits 86,87 in the side walls 44,45 of the cutting/storagemember 50 and pushing the cut pieces out from the chamber. If analternative embodiment of the cutting/storage element 50 is used wherethe proximal end of the storage chamber 88 is closed only during use,the cut pieces may be pushed out of either end of the storage chamber88. Similarly, if a disposable straw 90 is used, the cut piecescontained within the straw 90 may be removed by using a stylet to thepush the cut pieces out of either the proximal or the distal end of thestraw 90 which are both open when not in use.

Further, the improved surgical rongeur of the present invention may bepowered by alternative power sources such as electricity, via a cord orbattery supply, pneumatic power, or other power sources can be employed.In a powered rongeur, the finger grip of the rongeur can then be devotedto turning on and off the power supply source to drive the instrument.If gas or other fluid is used, a pressure relief valve is preferablyincorporated within the fluid line to establish a limit pressure, whichmay be set to the maximum desired biting force to be delivered.

Referring to FIG. 11, an electrically powered rongeur 200 is shown. Therongeur 200 comprises a housing 201 having a grip 202 that is adaptedfor receiving a rechargeable battery pack 204 and related electroniccircuitry 206. The battery pack 204 is removably inserted into the grip202 through an opening at the base of the grip 202 and has spring clips207 on either side of the battery pack 204 which fit into correspondingopenings 208 in the grip 202 and lock into place. The battery pack 204is removed by depressing the spring clips 207 so that they are out ofthe openings 208 and the battery pack 204 is easily removed from withinthe grip 202. It is appreciated that in a simple variation of thisembodiment, the battery pack 204 itself may serve as a removablyattachable handle instead of fitting within the grip 202. In this mannerthe battery pack 204 may be easily replaced by the surgeon.

The battery pack 204 has contacts 209 for electrical coupling to anactivation switch 210. The activation switch 210 is operated by thedepression of a trigger 212 and is electrically coupled to theelectronic circuitry 206 via contacts 209. The activation switch 210 isused for controlling the power supplied to a solenoid 214 located abovethe grip 202 and within the housing 201. The solenoid 214 iselectrically coupled to the electronic circuitry by contacts 209. Therear portion of the housing 201 can be opened for access to thecompartment by the removal of cap 216 which is threadably attached tothe housing 201. Prior to sterilization, the cap 216 and the solenoid214 can be removed from the housing 201. The rongeur 200 can besterilized. It is appreciated that all of the electrical components ofthe electrical rongeur 200 may have contacts 209 such that theelectrical components may be easily removed and replaced without theneed for wiring these components.

The solenoid 214 drives a reciprocating rod 210 which is removablycoupled at its distal end 220 to a cutting/storage member 222 andterminates in a proximal end portion 224. The proximal end portion 224is made of a non-ferrous material, such that the proximal end portion224 is not affected by the electromagnetic field generated by thesolenoid 214. The rod 218 is spring biased by a strong spring 226 in theproximal direction to maintain the rod 218 in a maximally, proximalposition and thus maintain a gap between the foot plate 16 and thecutting edge 22 of the cutting/storage member 222. Near the proximal endportion 224 of the rod 218 is a plunger 228 having a bore 230 forreceiving at least a portion of the proximal end portion 224. Theplunger 228 is made of a ferrous material such that the plunger 228 isresponsive to the electromagnetic field generated by the solenoid 210.When the solenoid 210 is powered, the plunger 228 is driven forward inthe distal direction, driving the rod 218 in the same direction towardthe foot plate 16 such that the cutting edge 22 of the cutting/storagemember 222 contacts the foot plate 16. The rod 218 is then returned toits proximal position by the spring 226. The proximal travel of theplunger 228 is stopped by stopper 232 made of a resilient andsterilizable material such as an appropriate plastic well known by thoseskilled in the art.

As a safety precaution, the momentum at which the rod 218 is drivenforward toward the foot plate 16 may be set to a desired rate, such thatexcessive force is not exerted on the cutting edge 22 and the foot plate16. Further, the rod 218 can be adjustable along the longitudinal axis,either by threads or other means, such that a precise closing of thecutting edge 22 against the foot plate 16 is achieved. In this manner,any other tendency of the cutting edge 22 to continue distally placingfurther stress on the foot plate 16 is avoided.

The depression of the trigger 212 closes the switch 210 to cause oneclosing and opening of the rongeur 200. For a second closing operation,the trigger 212 must be released and then depressed again in order toclose switch 210 once again. A safety mechanism for preventingactivation of the switch 210, well known in electrically operateddevices, can be included. Such a safety mechanism could consist of amechanical interference between the trigger and the switch to preventactivation of the switch 210 or a second trigger may be placed in aseparate location on the grip 202 to insure that activation of therongeur occurs only when both the trigger 212 and the second trigger aredepressed to avoid accidental activation of the rongeur 200.

Referring to FIGS. 11-14, the cutting/storage member 222 is a hollowtube for containing multiple cut pieces of bone or cartilage, having asharp cutting edge 22 and an engagement end 234 for removably engagingthe rod 218. The cutting/storage member 222 is slidable within a shafthousing 236 which remains stationary as the cutting/storage member 222reciprocates along the shaft 238 in rectilinear motion. Although theshaft housing 236 has been described and shown as being a single piece,it is appreciated that shaft housing 236 may comprise a number ofseparate pieces spaced apart along the shaft 238 while still beingcapable of housing the cutting/storage member 222. Engagement end 234 isclosed when in use, but once the cutting/storage member 222 is removedfrom within the shaft housing 236, it is open such that bone may bepushed from one end of the cutting/storage member 222 out the other endwith the use of an obdurator or other similar instrument.

The shaft housing 236 removably engages the shaft 238 in the same mannerin which the cutting/storage member 50 (described above) removableattaches to shaft 14 as described in detail above. Like thecutting/storage member 50, the shaft housing 236 has forwardrail-engaging members 53,54 which fit within the forward notches 65,66of shaft 238 and rear rail-engaging members 56,57 which are sufficientlyspaced proximally from the forward rail-engaging members 53,54 so thatwhen the forward rail-engaging members 53,54 are placed over forwardnotches 65,66, the rear rail-engaging members 56,57 are directly overthe rear notches 69,71 in the shaft 238. The shaft housing 236 is thenslid in the distal direction toward foot plate 16, such that the forwardrail-engaging members 53,54 and the rear rail engaging members becomeengaged to the rails 62,63, and the shaft cover 236 is prevented fromsliding upward and becomes locked to the shaft 238.

Referring still to FIG. 11, to ensure that shaft cover 236 stays lockedto the shaft 238, a biasing spring 240 is located within the housing 201and maintains the shaft housing 236 biased in a maximal distal position.During the removal of the shaft housing 236, the shaft housing 236 ismoved proximally to compress the biasing spring 240 and permit the shafthousing 236 to become disengaged from the shaft 238.

Referring to FIG. 14, a top plan view of the connections between thecutting/storage member 222 and the rod 218 is shown. The engagement end234 of the cutting/storage member 222 has a female connection means 242comprising radiused portions 244 a and 244 b on both sides such that acorresponding male connection means 246 on the rod 218 fits into thefemale connection means 242. The cutting/storage member 222 may beengaged to the rod 218 by removing the shaft housing 236 and thenlowering the cutting/storage member 222 onto the shaft 238 so that thefemale and male connection means 242 and 246, respectively, engage. Theshaft housing 236 is then replaced and locked to the shaft 238 asdescribed above. To disengage the cutting/storage member 222 from therod 218, the shaft housing 236 Is disengaged from the shaft 238 bysliding the shaft housing 236 in the proximal direction to compress thebiasing spring 240, the shaft housing 236 is lifted off, and then thecutting/storage member 222 is easily lifted out.

In use, the surgeon would insert the rongeur 200 around the bone to becut and the trigger 212 would be pulled. The pulling of the trigger 212would cause the rod 218 and the cutting/storage member 222 to be drivenforward to close against the foot plate 16 cutting the bone and thecutting/storage member 222 and the foot plate 16 are returned to theiroriginal open position regardless of the trigger 212 being released orleft depressed. This occurs because the delivery of electrical currentto the solenoid 214 is interrupted by the electronic circuitry 206 andthe strong return spring 226 returns the cutting/storage member 222 andthe foot plate 16 to their original open position. Releasing the trigger212 would permit the cutting/storage member 222 to return to its openposition. The surgeon would then move the rongeur 200, without removingthe rongeur 200 from the wound, to the next area of bone requiringbiting, and again activate the trigger 212 and cause the rongeur 200 toclose. The power rongeur 200 may be modified for use with any of thecutting/storage members described herein, such as the first embodimentdescribed above in reference to FIG. 1.

Referring to FIG. 15, rongeur 200 a is shown which is an alternativeembodiment of rongeur 200. In this embodiment, rongeur 200 a has areciprocal rod 218 a coupled to the slide drive member 20 by a resilentcompressible member 221 described in detail in copending applicationSer. No. 07/398,987 filed on Aug. 28, 1989 incorporated by referenceherein. The function of the rongeur 200 a is the same as described abovefor rongeur 10, except that it is powered electrically. It is alsoappreciated that any of the embodiments of the rongeur of the presentinvention may be similarly adapted to become electrically poweredwithout departing from the scope of the present invention.

The rod 218 a has a non-ferrous portion 260, a ferrous portion 262, andterminates proximally in a threaded end portion 264. Threadably attachedto the threaded end portion 264 is a disc 266 which functions to stopthe distal travel of the rod 218 a as it is advanced through thesolenoid 214 by making physical contact with the solenoid 214. As thedisc 266 is threadably attached to the threaded end portion 264, thedistal travel of the rod 218 a may be regulated by varying how far thethreaded end portion 264 is threaded into the disc 266 resulting in achange in the length of the rod 218 a passing through the solenoid 214.To shorten the distance of the distal travel by the rod 218 a, thethreaded end portion 264 is threaded further into the disc 266. If agreater distance of travel of the rod 218 a is desired, the disc 266 isunscrewed such that less of the threaded end portion 264 is threadedinto the disc 266. In this manner, the force generated by the activationof the solenoid 214 is may be adjusted by varying the length of the rod218 a passing through the solenoid 214.

Referring to FIG. 16, an alternative embodiment of the power rongeur ofthe present invention is shown and generally referred to by the numeral300. The rongeur 300 comprises a primary solenoid 302, a plunger 304, asmaller secondary solenoid 306, electronic circuitry 307 and areciprocating rod 308. The primary solenoid 302, the secondary solenoid306 and the electronic circuitry 307 are electrically coupled viacontacts 309 to facilitate removal and replacement of those componentswithout having to detach and reattach any wires. The reciprocating rod308 has a proximal end comprising a first nonferrous portion 310, aferrous portion 312, and a second nonferrous portion 314. Thesecondary-solenoid 306 is much smaller and less powerful than theprimary solenoid 302. When the secondary solenoid 306 is activated, theelectromagnetic field created urges the reciprocating rod 308 in thedistal direction such that the ferrous portion 312 moves distally withinthe electromagnetic field of the secondary solenoid 306. In thisposition, the reciprocating rod 308 is positioned in a distal directionsufficient to place the cutting edge 22 of the cutting/storage element236 (shown in FIG. 11) in contact with the bone to be cut. It isimportant to note that the purpose of the secondary solenoid 306 ismerely to advance the reciprocating rod 308 a sufficient distance tobring the cutting edge 22 in contact with the bone to be cut, but not tocut the bone.

Once the cutting edge 22 is properly positioned at the site in which acut is desired through the activation of the secondary solenoid 306, theprimary solenoid 302 is activated and the plunger 304 is driven in thedistal direction to provide a high impact force to the reciprocating rod308 and the desired cut is performed. At that point in time, thedelivery of electrical current to the primary solenoid 302 and thesecondary solenoid 304 stops and the reciprocating rod 308 is thenreturned to its maximal proximal position by the biasing spring 240regardless of whether the trigger 212 is released or left depressed. Theplunger 304 is returned to its starting position by the spring 313 whichis coupled to the removable cap 315.

The supply of electrical current to the primary solenoid 302 andsecondary solenoid 306 is controlled by a trigger 316 which closes anactivation switch 318 having two stages. In the first stage, the trigger316 is only partially depressed, such that the activation switch 318delivers electrical current only to the secondary solenoid 306 forpositioning the cutting edge 22 against the bone to be cut. The deliveryof electrical current to the secondary solenoid 306 ceases immediatelyupon the release of the trigger 316 permitting the surgeon to repositionthe rongeur 300 prior to cutting the bone. In the second stage, thetrigger 316 is fully depressed such that the activation switch 318delivers electrical current to the primary solenoid 302 while continuingto deliver electrical current to the secondary solenoid 306.

The full depression of the trigger 316 causes one closing and opening ofthe rongeur 300. For a second closing operation, the trigger 316 must bereleased and then depressed again in order to close switch 210 onceagain. It is appreciated that the first stage activation of thesecondary solenoid 306 may be bypassed if a surgeon desires to make animmediate cut without first positioning the cutting edge 22 against thebone by fully depressing the trigger 316 at once to power the primarysolenoid 302

Further, the electrical rongeur 300 may include a force adjusting meansfor adjusting the cutting force of the rongeur 300. In one embodiment,such a force adjusting means may include an angled threaded opening 350in the housing 301 for receiving a threaded member 352 therein. Thethreaded member 352 is threaded into the opening 350 such that the head354 of the threaded member 350 sufficiently extends to limit the distalmotion of the rod 308 by making contact with the oversized portion 356of the rod 308. It is appreciated that the further the threaded member352 is threaded into the opening 350 the greater the limitation of thedistal motion of the rod 308 and thus the lesser is the cutting force.It is further appreciated that the cutting force of the rongeur 300 canbe limited electronically by controlling the amount of current that isdelivered to the primary solenoid 302. Such an electronic means is wellknown by those skilled in the art.

Referring to FIGS. 17-25, an alternative embodiment of a surgicalrongeur made in accordance with the present invention is shown andgenerally referred to by the numeral 400. The rongeur 400 is similar instructure to the rongeur 10 in the embodiment described above, exceptthat it has an improved button assembly 420 and an improvedcutting/storage member 430.

Referring specifically to FIG. 17, the improved button assembly 420functions to control the displacement of the slide drive member 20 alongthe shaft 14 in order to release or to engage the cutting/storage member430 from the shaft 14 as described above. The improved button assembly420 is located near the proximal end 11 of the shaft 14 and fits in theopening 15 to replace the pivot pin 32. In this manner, the improvedbutton assembly 420 also serves as a pivot pin and attachment means forfront handle 30.

Referring to FIG. 20, the improved button assembly 420 comprises abutton member 422 having a large diameter portion 424 and a narrowdiameter portion 426 with a threaded end 427. The narrow diameterportion 426 fits through a hollow sleeve member 428 and threads to asubstantially flat member 440 having a threaded opening 441 and islocated on the opposite side of the body 12 of the rongeur 400. Thehollow sleeve member 428 acts as a bushing about which the front handle30 pivots during the operation of the rongeur 400. Between the buttonmember 422 and the substantially flat member 440 is a coiled spring 442that maintains the button member 422 in a biased position.

Referring to FIGS. 18 and 19, a front elevational view along lines 18-18of FIG. 17 of the button assembly 420 in the biased position is shown.The substantially flat member 440 has a extension pin 446 that functionsto limit the travel of the slide drive member 20 towards the proximalend 11 of the shaft 14. In the biased position, the extension pin 446 ispositioned such that it is between the top part 448 of the forwardhandle 30 and the body 12 to create space S so as to keep the slidedrive member 20 in a more distal position. In this manner, thecutting/storage member 430 is engaged to the shaft 14 and is in thelocked position as discussed above for the preferred embodiment of thesurgical rongeur 10.

Referring to FIG. 19, a front elevational view along lines 18-18 of thebutton assembly 420 is shown in the unbiased positioned that is achievedwhen the button assembly 420 is depressed in the direction indicated byarrow A. The top part 448 of the front handle 30 has a notch 450 capableof receiving at least a portion of the extension pin 446 when the buttonassembly 420 is in the unbiased position. In the unbiased position, theextension pin 446 no longer keeps the top part 448 of the forward handle30 away from the body 12 of the rongeur 400 such that space S iseliminated and the slide drive member 20 is moved in a more proximaldirection which allows the cutting/storage member 430 to be disengagedand removed from the shaft 14. When the extension pin 446 is in thenotch 450, the button assembly 420 is prevented from returning to itsnormal biased position because the wall 452 of the notch 450 preventsthe travel of the extension pin 446 in that direction.

When the front handle 30 is squeezed by the surgeon, the front handle 30moves in the direction of the rear handle 13 and away from the body 12of the rongeur 400 creating the space S between the top part 448 of thefront handle 30 and the body 12. In this position, the extension pin 446is no longer contained within the notch 450 and moves, as result of theforce of the coiled spring 454, into the space S that is created betweenthe top part 448 of the forward handle 30 and the body 12 of the rongeur400. Once the front handle 30 is released by the surgeon, the top part448 of the front handle 30 rests against the extension pin 446 and iskept at a distance from the body 12 that is equal to the diameter of theextension pin 446. As a result, the rongeur 400 is self-locking simplyby the squeezing of the front handle 30.

Referring to FIGS. 21 and 22, the improved cutting/storage member 430 isshown comprising a removable and disposable straw 460 which is a hollowmember that is similar in structure to the straw 90 as described above.The distal end of the straw 460 is a sharp cutting edge 462 for cuttingbone or other similar tissue. The straw 460 is affixed to the bottom ofa slideable shaft housing 470 which is similar in construction to thecarriage member 96 described above but has a straw engagement means 472for removably engaging the straw 460 to the modified cutting/storagebase 470.

Referring to FIG. 23, an enlarged cross sectional view of the strawengagement means 472 is shown comprising a pivoting member 474 and adetent means 476. The detent means 476 comprises a housing 478 forcontaining a spring means 480 for spring loading a detent ball 482. Afirst end 484 of the pivoting member 474 is connected to the detent ball482 and is maintained by the detent means 476 in a raised position or ina lowered position as shown in broken lines in FIG. 23. A second end 486of the pivoting member 474 is capable of receiving the proximal end ofthe straw 460 and has a lip 485 so that the pivoting member 474 may belifted to the raised position in the absence of a straw 460 in order topermit engagement of the straw 460 to the pivoting member 474.

Referring to FIG. 24, a cross sectional view of the cutting/storagemember 430 along lines 24-24 of FIG. 22 is shown. Extending from thesecond end 486 of the pivoting member 474 is a stabilizer pin 488 whichfits into a corresponding opening 490 located near the proximal end ofthe straw 460 and functions to stabilize the straw 460 once the pivotingmember 474 is inserted within the second end 486 of the straw 460. Thestabilizer pin 488 prevents rotational movement and distal movement ofthe straw 460 during the operation of the rongeur 400.

Referring back to FIG. 21, the straw engagement means 472 functions tofacilitate the attachment and the removal of the straw 460 to the shafthousing 470. Prior to use, the straw 460 is placed in the shaft housing470 so that it engages the pivoting member 474 in the raised positionprior to placing the shaft housing 470 on the shaft 14. Once the straw460 is engaged to the straw engagement means 472, the straw 460 islowered towards the shaft housing 470 such that the straw 460 wedgesinto converging trapezoidal walls 473A and 473B and the detent means 476keeps the straw 460 pressed into a stable wedged position, and preventsany movement of the straw 460 within the shaft housing 470 during theoperation of the rongeur 400.

To remove the straw 460, once the shaft housing 470 is removed from theshaft 14, the straw 460 is lifted away from the shaft housing 470 suchthat the pivoting member 474 is returned to its raised position. Thesurgeon then simply pulls the straw 460 away from the pivoting member474 and engages a new straw 460 to the pivoting member 474. The bonecontained within the first straw 460 may then be harvested and the firststraw 460 may then be disposed.

Referring to FIG. 25, an alternative embodiment of the straw engagementmeans 500 having a pivoting member 510 that pivots about an axis 520 andhas a first end 522 with notches 524 a and 524 b each capable ofreceiving at least a portion of the detent ball 530 therein. Thepivoting member 510 has the same function as the pivoting member 474described above, and the notches 524 a and 524 b function to maintainthe pivoting member 510 in the lowered or raised position, as describedabove for the straw engagement means 472. As the pivoting member 570pivots about the axis 520, the detent ball 530 engages one of thenotches 524 a or 524 b to hold the pivoting member 570 in a raised orlowered position. The pivoting member 570 has an extension pin 588 thathas the same structure and function as the extension pin 488 describedabove and a lip 585 that has the same structure and function as the lip485 described above.

Referring to FIG. 26, an alternative embodiment of the present inventionis shown and generally referred to by the numeral 600. The rongeur 600comprises of a body 610 having a rear handle 612 depending at an anglefrom the proximal end 614 of the body 610, and has an upper body portion616 terminating into a removable cutting/storage element 50. The upperbody portion 616 is fixed and is capable of housing and slideablyreceiving a reciprocating shaft 618 which terminates in a foot plate 16.The reciprocating shaft 618 is driven by a front handle 620 which ispivotably attached to the body 610. The front handle 620 drives thereciprocating shaft 618 via a toothed gear 622 which engages acorrespondingly toothed track 624 of the reciprocating shaft 618 whilethe body 610 remains stationary. In this embodiment, the cutting/storageelement 50 remains in a fixed position while the shaft 618 reciprocatesduring the cutting action of the rongeur 600 to bring the foot plate 16into contact with the cutting/storage member 50.

Referring to FIG. 27, an alternative embodiment of the surgical rongeurof the present invention is shown and generally referred to by thenumeral 700. The rongeur 700 comprises a body 712 having a shaft 714extending distally with a removable portion 715. The removable portion715 has its distal end terminating in a foot plate 716 and its proximalend having a double-key, male member 718 for engaging a correspondingfemale member 720 located at the distal end of the shaft 714.

Referring to FIG. 27A, the male member 718 is shown fully seated withinthe female member 720 to provide a stable coupling capable of enduringthe above-described forces encountered during the operation of therongeur 700. The removable portion 715 provides the added advantage ofallowing the surgeon to easily replace at least a portion of the shaft714, such as the foot plate 716, along with replacing thecutting/storage member if desired, as described in detail for theembodiments set forth above.

It is appreciated that an important advantage of the removable portion715 is that multiple removable portions 715 of various sizes and lengthshaving various foot plates 716 can be made available to the surgeonappropriate for the particular surgical procedure being performed by thesurgeon. In this manner the versatility of the rongeur 700 is greatlyincreased, the need for having multiple rongeurs of different sizes andconfigurations is eliminated greatly reducing cost, especially if therongeur 700 is power actuated.

For example, the removable portion 715 may have a foot plate 716 that isangled relative to the shaft 716 in a specific orientation for aparticular surgical procedure such that a number customized removableportions 715 may be provided for use with a common body, handle andshaft 714. The removable portion 715 may have different lengths,diameters and the overall configuration of the removable portion 715 maybe rounded for use in endoscopic procedures as described in reference toFIGS. 28 and 29 set forth in detail below.

Further, the structure of the rongeur 700 allows for a variety ofdifferent sizes and configurations of removable portion 715 and footplate 716 to be interchangeably utilized with a common handle, body, andshaft 714. Additionally, the structure of the rongeur 700 allows for thereplacement of both cutting edges—the cutting/storage member and thefoot plate 716—when it is desired to incorporate a cutting surface thatis out of the plane of the surface 730 on the foot plate 716 sufficientto provide a cutting surface but not to hold a substantial amount ofbone such that it would prevent the bone from being advanced into thecutting/storage member. When the foot plate 716 contains such a cuttingsurface, it is preferable that the entire removable portion 715 bedisposable such that fresh, sharp cutting surfaces are provided witheach use.

Referring to FIG. 27B, a partial side sectional view of an alternativeembodiment of the rongeur 700 having a foot plate 716 a with a cuttingsurface 740 which is out of the plane of the surface 730 of the footplate 716 a facing the cutting edge 742 of the cutting/storage member750 is shown. The cutting surface 740 is slightly raised from thesurface 730 such that the cutting surface 730 and the cutting edge 742contact and mate during the cutting of bone or cartilage. The cuttingedge 742 is preferably sharpened only on the interior side 754 of thecutting/storage member 750.

Referring to FIG. 27C, an alternative embodiment of the foot plate 716 aof FIG. 27B is shown and generally referred to by the numeral 716 b. Thefoot plate 716 b has a cutting surface 740 a which is out of the planeof the surface 730 facing the cutting edge 742 a of the cutting/storagemember 752. In this embodiment, the cutting surface 740 a is below theplane of the surface 730 such that the cutting edge 742 a of thecutting/storage member 752 is received within the cutting surface 740 a.The cutting edge 742 a is preferably sharpened on both the interior side754 and the exterior side 756 such that the cutting edge 742 a is aknife-like edge.

Referring to FIGS. 28 and 29, an alternative embodiment of the surgicalrongeur of the present invention for use in endoscopic surgicalprocedures is shown and generally referred to by the numeral 800. Theendoscopic rongeur 800 has a shaft 814 and a cutting/storage member 850that are preferably rounded over their entire length, but may be morelimitedly rounded in a particular area such as the area of the shaft andhandle junction. The cutting/storage member 850 preferably has a straw890 similar to the straw 90 described above in reference to FIGS. 8 and9, and having a semi-circular cross section to maximize the biting andstorage area of the endoscopic rongeur 800. Such an overall roundedconfiguration facilitates the passage of the endoscopic rongeur 800through the skin and flesh or as more commonly practiced through acannula typically used for such endoscopic surgery to pass through theskin and soft tissue of the patient and into the abdomen, thorax, orwithin other areas of the body while still allowing for a good sealagainst gas or fluid leakage from within the body of the patient.

Referring specifically to FIG. 29, a cross sectional view of theendoscopic rongeur 800 is shown illustrating the overall circulardiameter of the shaft 814 and cutting/storage member 850. It isappreciated that in order to better form a seal with the opening in thebody of the patient, the cutting/storage member 850 may be slideablewithin a fixed exterior housing, such as shaft housing 236, describedabove for the embodiment shown in FIGS. 11-14. Such an exterior housingwould also have an overall circular diameter. In this manner, once theendoscopic rongeur 800 is placed within the opening in the body, theseal formed between the fixed exterior housing and the opening of thepatient is maintained relatively undisturbed.

The endoscopic rongeur 800 preferably has an overall length ofapproximately 13.0 inches (330.2 mm) to 18.0 inches (457.2 mm), with ashaft length measured from the foot plate to the handle of approximately10.5 inches (266.7 mm) to 13.0 inches (330.2 mm), and a shaft diameterof approximately 3/16 inches (4.0 mm) to ½ inch (12.0 mm), andpreferably ⅓ inch (8.0 mm).

It is appreciated that the endoscopic rongeur 800 can be activatedmanually by rear handle 13 and forward handle 30 described above, havingan overall length of approximately 3.5 inches (88.9 mm) to 6.0 inches(152.4 mm). It is further appreciated that the endoscopic rongeur 800may be power actuated by any of the power means described above inreference to FIGS. 11-16.

Referring to FIGS. 30-32, an alternative embodiment of the surgicalrongeur of the present invention is shown and generally referred to bythe numeral 900. The rongeur 900 comprises a removable unit 902 whichremovably engages a body 912. The removable unit 902 comprises a shaft914 terminating in a foot plate 916 and a cutting/storage member 950.The removable unit 902 has a pair of engagement members 920 and 922which are identical and fit into corresponding slots 924 and 924 in thebody 912. Each of the engagement members 920 and 922 comprise a flexibleupper tyne 930 and a flexible lower tyne 932 sufficiently spaced apartto permit the upper and lower tynes 930 and 932 to flex toward eachother.

Near the proximal end of the engagement members 920 and 922, each of theupper and lower tynes 930 and 932 have protuberances 934 a and 934 b onthe external surfaces and radiused portions 936 a and 936 b on theinterior surfaces to form a substantially circular recess 938. Theprotuberances 936 a and 936 b fit into corresponding notches 940 a and940 b formed in slot 924.

Referring specifically to FIG. 31, engagement member 920 is shown beingpartially inserted into slot 924 with the upper and lower tynes 930 and932 being flexed toward each other as a result of the protuberances 934a and 934 b contacting the walls of the slot 924. Located at the end ofthe slot 924 is a detent means 942 comprising a barrel member 946connected via shaft 948 to a tab member 952 situated within an opening956 in the body 912 proximate the slot 924. The detent means 942 isbiased distally by spring 954 such that when the proximal ends of theupper and lower tynes 930 and 932 contact the barrel member 946, thespring 956 compresses to permit the upper and lower tynes 930 and 932 tobe further inserted into the slot 924 until the protuberances 934 a and934 b coincide in position with the notches 940 a and 940 brespectively. As the protuberances 934 a and 934 b are entering thenotches 940 a and 940 b, respectively, the barrel member 946 forcesapart the upper and lower tynes 930 and 932, and the spring 956 biasesthe barrel member 946 distally into the recess 938.

Referring to FIG. 32, engagement member 920 is shown fully inserted andseated within the slot 924 with the protuberances 934 a and 934 b fullyseated within the notches 940 a and 940 b, respectively, and the barrelmember 946 is fitted within the recess 938 to maintain the appropriatespacing between the upper and lower tynes 930 and 932 such that theprotuberances 934 a and 934 b remain fully seated within the notches 940a and 940 b, respectively, and the removable unit 902 is locked intoplace to the body 912 and can not be removed unless it is unlocked bythe surgeon. The removable unit 902 remains locked to the body 912 foras long as the barrel member 946 is situated within the recess 938.

To unlock the removable unit 902 from the body 912, the tabs 952 foreach of the engagement members 920 and 922 are moved in the proximaldirection by the surgeon such that the barrel member 946 is removed fromwithin the recess 938 and the upper and lower tynes 930 and 932 can beflexed toward each other as the removable unit 902 is pulled away fromthe body 912 such that the protuberances 934 a and 934 b exit thenotches 940 a and 940 b, respectively.

The rongeur 900 provides the ideal means for having both cuttingelements—the cutting/storage member 950 and the foot plate 916—beingreplaceable when a second cutting element is present in the form of araised and sharpened cutting edge on the foot plate 916 sufficient toprovide a cutting edge but not to hold a substantial amount of bone suchthat it would prevent the bone from being advanced into thecutting/storage member 950. When the foot plate 916 contains a cuttingedge, it is preferable that the entire end unit 902 be disposable suchthat fresh, sharp cutting elements are provided with each use.

The rongeur 900 also provides the added advantages of having differentsizes and configurations of the removable end unit 902 which can be usedwith the same body 912 increasing the versatility of the rongeur 900,eliminating the need for having multiple rongeurs of different sizes andconfigurations and greatly reducing cost, especially if the rongeur 900is power actuated.

For example, the end unit 902 may have a foot plate 916 that is angledrelative to the shaft 916 in a specific orientation for a particularsurgical procedure such that a number of specialized end units 902 maybe provided for use with the body 912. The end unit may have a shaft 914and cutting/storage member 950 of different lengths, diameters and theoverall configuration of the end unit 902 may be rounded for use inendoscopic procedures as described in reference to FIGS. 28 and 29. Insuch cases, the entire end unit 902 may be entirely disposable or theend unit 902 may comprise any of the cutting/storage members describedabove having a disposable portion such as the straw 90 described abovein reference to FIGS. 8 and 9.

It is further appreciated that while the body 912 is shown with amanually operated handle, any of the embodiments of the power handlesdescribed above in reference to FIGS. 11-16 may be modified to drive therongeur 900 without departing from the scope of the present invention.

Referring to FIG. 33, an alternative embodiment of the rongeur of thepresent invention is shown and generally referred to by the numeral1000. Rongeur 1000 has a shaft 1014 and a cutting/storage member 1050that are preferably rounded over their entire length, but may be morelimitedly rounded in the area of the shaft and handle junction. Thecutting/storage member 1050 preferably has a straw 1090 similar to thestraw 90 described above in reference to FIGS. 8 and 9, except that itis in communication with a vacuum pump 1092 via a hose 1094. The vacuumpump 1092 functions to evacuate any cut pieces of bone or cartilage andcogenerated debris from the straw 1090 resulting from the cutting actionof the rongeur 1000. The hose 1094 forms an airtight seal with the straw1090 to prevent vacuum loss and any contamination of the wound with thecut pieces of bone or cartilage or cogenerated debris. The use of avacuum pump 1092 or similar means well known by those skilled in the artin association with rongeur 1000 is especially advantageous when therongeur 1000 is being used in endoscopic surgical procedures where thepresence of cut pieces of bone or cartilage and/or cogenerated debrisinterferes with the endoscopic procedure.

While the rongeur 1000 has been described with the cutting/storagemember 1050 having a straw 1090 in communication with the vacuum pump1092, it is appreciated that any of the embodiments of thecutting/storage member described above may also be modified to be incommunication with vacuum pump 1092 or similar means well known by thoseskilled in the art to evacuate any cut pieces of bone or cartilageand/or cogenerated debris from the cutting/storage member withoutdeparting from the scope of the present invention. While the presentinvention has been described in association with the preferredembodiment and several alternative embodiments, it is recognized thatother variations of the present invention may be made without departingfrom the scope of the present invention. Further, it is appreciated thatany of the manually activated embodiments of the rongeurs describedabove may also be made to be electrically powered and similarly theelectrically powered embodiment may also be made to be manuallyactivated without departing from the scope of the present invention.

1. A rongeur for cutting tissue including bone or cartilage, saidrongeur comprising: a body; a first shaft and a second shaft extendingfrom said body and capable of reciprocating motion relative to eachother, said first shaft terminating in a foot plate, said second shaftincluding a combined cutting element and storage member having a leadingend and a trailing end opposite said leading end, said leading endhaving a first opening and a cutting edge adapted to contact said footplate, said cutting edge and said foot plate moveable from an openposition to a closed position, the maximal volume of the tissue capableof being cut when said cutting edge and said foot plate are moved fromsaid open position to said closed position determining a full cut of thetissue; a storage area in communication with said first opening in saidleading end of said combined cutting element and storage member, saidstorage area configured to collect and store more than two full cutpieces of the tissue within said storage area, said combined cuttingelement and storage member in cooperation with said rongeur preventingthe ejection of the full cut pieces of the tissue from said storage areaduring operation of said rongeur; and an actuator associated with saidfirst and second shafts for providing reciprocating motion between saidfirst and second shafts.
 2. The rongeur of claim 1, wherein saidcombined cutting element and storage member is removeably coupled to atleast a portion of said second shaft.
 3. The rongeur of claim 1, whereinsaid trailing end of said combined cutting element and storage memberincludes a second opening at said trailing end in communication withsaid storage area, said second opening adapted to be closed by a portionof said rongeur when in use.
 4. The rongeur of claim 3, wherein saidsecond opening is in communication with a vacuum for evacuating anycontents of said combined cutting element and storage member.
 5. Therongeur of claim 1, wherein said foot plate comprises a cutting surfacewhich is out of the plane of the surface of the foot plate facing thecutting edge of said combined cutting element and storage member.
 6. Therongeur of claim 1, wherein said combined cutting element and storagemember includes at least a portion thereof that is replaceable.
 7. Therongeur of claim 1, wherein said combined cutting element and storagemember is at least partially disposable.
 8. The rongeur of claim 1,wherein said actuator for providing said reciprocal motion of said firstand second shafts relative to one another includes a solenoid.
 9. Therongeur of claim 1, wherein said first and second shafts are configuredto form a seal against gas or fluid leakage from within the body of apatient through which said rongeur passes during endoscopic surgicalprocedures.
 10. The rongeur of claim 1, wherein at least one of saidfirst and second shafts is removeably attached to said actuator.